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Adam Strain is one of five children whose deaths are being investigated

Clinicians recalled to give evidence at an inquiry into the death of a child at a NI hospital have been accused of "clouding rather than clarifying issues".

Adam Strain, four, died following a kidney transplant at the Royal Victoria Hospital, Belfast, in 1995.

Chairman John O'Hara QC said their evidence appeared to contradict that contained in a recently found document.

The inquiry is probing the deaths of five children.

Appearing before the inquiry on Friday was consultant paediatric surgeon Stephen Brown.

He assisted in Adam's transplant operation.

Dr Brown is one of several senior clinicians who are being recalled by the inquiry.

It follows the discovery of a document, written 16 years ago.

It records a meeting which took place prior to Adam Strain's inquest where doctors and surgeons gave their accounts of what happened during the child's kidney transplant.

Some of the information contradicts testimonies provided by the clinicians both earlier in the inquiry and to police before Adam's inquest.

The note records the clinicians saying that the kidney was not performing well and that a needle was inserted into the artery and no blood came out.

Dr Brown disputes this ever happened.

Giving evidence, Dr Brown admitted he could not remember a lot of the detail about the child's operation.

The inquiry chairman, Mr O'Hara, said it was very curious that Mr Brown's "memory of the operation was so thin" as Adam's death soon became "the talk of the hospital".

Giving evidence, Patrick Keane a consultant Urologist at Belfast City Hospital and who was Adam's transplant surgeon, questioned the accuracy of the notes recorded in the document.

Referring to one particular paragraph which the Inquiry has been focussing on over the past two days, Mr Keane said as much as he could recall a needle was not put into an artery.

He said that would never have happened.

"If you were to do that - put a needle into the artery - it would require an assistant to stretch it, so to do it on your own would be quite a performance, in fact if it was done it would be bordering on the wreckless," he said.

Mr Keane said there were "huge medical errors in the note".

In response to the clinicians, including Mr Keane, questioning the accuracy of the document, Mr O'Hara said it was equally curious to think that the paralegal would have inserted her own words.

Mr O'Hara said unless told differently he would accept the paralegal's notes as being correct.

On Thursday, Mr O'Hara told the inquiry he was concerned that fresh evidence appeared to suggest someone was not telling the truth.

During Friday's hearing Mr O'Hara said it was significant that the document was not presented to the inquest, nor to the police when they were gathering evidence after the child's death nor was it given to the inquiry.

On Thursday he said he believed this document was never meant to have seen the light of day.

A representative from the PSNI sat in the gallery on Friday making notes.

This is the first time this has happened since the clinicians gave evidence during the clinical proceedings of the Inquiry.

'Partially functioning'

At the centre of Adam's case is the condition of the donor kidney and whether surgery should have taken place.

Previously, some of Adam's clinicians told the court that during the operation the kidney was "partially functioning".

The hyponatraemia inquiry is investigating the deaths of Adam, Claire Roberts, Raychel Ferguson and Lucy Crawford, as well as issues arising from the treatment of Conor Mitchell.

They all received treatment in hospitals in Northern Ireland between 1995 and 2003.

Hyponatraemia is an abnormally low level of sodium in blood and can occur when fluids are given incorrectly.

The inquiry, which is being held at Banbridge Court House, resumed on Thursday after a summer recess.